Waist circumference home measurement--a device to find out patients in cardiovascular risk.
BACKGROUND
New strategies are needed to prevent the global epidemic of diabetes and subsequent rise in cardiovascular diseases. We describe a community-based, two-stage screening strategy using home waist circumference measurement and a risk factor questionnaire as a primary screening tool.


METHODS
We mailed a tape for measurement of waist and a risk factor questionnaire to every inhabitant aged 45-70 years living in the rural town of Harjavalta in Finland. Thereafter we performed an oral glucose tolerance test, anthropometric variables and blood pressure of subjects having at least one risk factor for type 2 diabetes or cardiovascular disease. People with previously known diabetes or vascular disease were excluded.


RESULTS
Seventy-three percent (2085/2856) of the invited inhabitants participated, and 84% of the respondents had at least one pre-specified risk factor. Waist circumference >or=80 cm in women and >or=94 cm in men (n = 1168), positive metabolic syndrome criteria of the International Diabetes Federation (n = 681) or the Finnish Diabetes Risk Score questionnaire >or=12 points (n = 697) identified 95, 92 and 63% of the new cases of type 2 diabetes and 84, 75 or 62% of pre-diabetes, respectively.


CONCLUSIONS
The International Diabetes Federation criteria for elevated waist circumference are very sensitive but lack specificity in diagnosing glucose disorders. The criteria for metabolic syndrome and the Finnish Diabetes Risk Score questionnaire are more efficient tools for the selection of patients for further risk stratification in general practise.
Korhonen
Päivi E
PE
Central Satakunta Health Federation of Municipalities, Harjavalta, Finland. paivi.e.korhonen@fimnet.fi
Jaatinen
Pekka T
PT
Aarnio
Pertti T
PT
Kantola
Ilkka M
IM
Saaresranta
Tarja
T
D000368:Aged; D002318:Cardiovascular Diseases / Q000209:etiology*; D005260:Female; D005387:Finland; D005951:Glucose Tolerance Test; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome; D008875:Middle Aged; D018570:Risk Assessment / Q000379:methods; D011795:Surveys and Questionnaires; D055105:Waist Circumference / Q000502:physiology*